Provider Demographics
NPI:1255854535
Name:ROLON RIVERA, DIANABEL
Entity type:Individual
Prefix:
First Name:DIANABEL
Middle Name:
Last Name:ROLON RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ESTANCIAS DE MONTE RIO STREET PRIMOROSA
Mailing Address - Street 2:NUMBER 77
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736
Mailing Address - Country:US
Mailing Address - Phone:787-738-8855
Mailing Address - Fax:787-738-8855
Practice Address - Street 1:CALLE JOSE DE DIEGO
Practice Address - Street 2:ESQUINA PALMER 12
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-8855
Practice Address - Fax:787-738-8855
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1339156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty